Collector II

2 weeks ago

Costa Mesa, United States ICONMA Full time
Description:
The Collector serves as the account representative for Client in working with insurance companies, government payors, and/or patients for resolution of payments and accounts resolution.
  • Obtains the maximum amount of reimbursement by evaluating claims at the contract rate with the use of the contract management tool for proper pricing (Examples: APC, DRG, APRDRG).
  • Reviews and initiates the initial appeal for underpayments observing all timely requirements to secure reimbursement due to Client.
  • Reviews and completes payor and/or patient correspondence in a timely manner.
  • Escalates to the payor and/or patient accounts that need to be appealed due to improper billing, coding and/or underpayments.
  • Reports new/unknown billing edits to direct supervisor for review and resolution.
  • Has a strong understanding of the Revenue Cycle processes, from Patient Access (authorizations & admissions) through Patient Financial Services (billing & collections), including procedures and policies.
  • Has thorough knowledge of managed care contracts, current payor rates, understanding of terms and conditions, as well as Federal and State requirements.
  • Interprets Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs) to ensure proper payment as well as assist and educate patients and colleagues with understanding of benefit plans.
  • Understanding of hospital billing form requirements (UB04) and familiar with the HCFA 1500 forms.
  • Knowledge of HMO, POS, PPO, EPO, IPA, Medicare Advantage, Covered California (Exchange), capitation, commercial and government payors (i.e. Medicare, Medi-Cal, TriCare, etc) and how these payors process claims.
  • Demonstrates knowledge of and effectively uses patient accounting systems.

Required skills & experience:
  • Minimum of 3 years' experience doing AR follow up with 50 claims per day
  • Working knowledge of Epic Resolute, Eric Care, and Epic CPOE.
  • Intermediate Excel knowledge is a must.

  • Collector II

    2 weeks ago

    Costa Mesa, United States DB HEALTHCARE INC Full time

    Job DescriptionJob DescriptionTitle: Collector II - CALocation: Costa Mesa, CA 92626Type: ContractDuration: 3 MonthsStart Date: 05/27/2024Positions: 1Role Type: Local candidates onlyJob Summary:The Collector serves as the account representative for Hoag in working with insurance companies, government payors, and/or patients for resolution of payments...

  • Collector II

    1 week ago

    Costa Mesa, United States PRIDE Healthcare Full time

    Job DescriptionJob DescriptionCollector IIPride Health is seeking a Collector for one of the large health systems based out of Costa Mesa, California.Location – Costa Mesa, California– 92626Pay range - $24 - $28 per hour.Length of assignment – 3 months (With Possible extension)Shift – Monday-Friday 1st shift.Job SummaryThe Collector serves as the...